The goal of this Mentored Patient-Oriented Research Career Award (K23), in response to PA 05-143, is to allow Dr. l-Chan Huang from the U. of Florida to become an independent researcher in the area of children's health-related quality of life (HRQOL) assessment, which measures physical and psychosocial functioning, and its clinical application. This training plan, through a combination of coursework, mentored research training and direct observation in pediatric clinics, provides Dr. Huang with the opportunity to enhance his 1) skills in item response theory (IRT) and computerized adaptive test (CAT) for HRQOL measurement;2) understanding of parent-child-physician interactions and barriers to using HRQOL measures in pediatric clinics;and, 3) knowledge of child health and development associated with HRQOL measurement. The resources at the University of Florida Department of Epidemiology and Health Policy Research and close contact with mentors will provide Dr. Huang with the ideal environment to achieve his goals. Parents report that HRQOL is one of their most important considerations in discussing treatment options with their children's physicians and in their decision making process. However, current conventional measurement methods require customized instruments for each illness (or the use of generic instruments that do not address disease-specific issues) and developmental stage and require administering the entire item set to each child. The use of IRT, combined with CAT technology, help adapt and tailor items to measure children's HRQOL more efficiently and precisely, and allows for comparison of children's HRQOL across developmental and illness trajectories. In this K23 award, Dr. Huang will use IRT and simulated CAT technology to develop children's HRQOL measures, focusing on creating HRQOL item pools and short-forms of the instruments that can be used in clinical settings. He will also explore the parents', children's and physicians'attitudes and barriers to using HRQOL in clinical settings. Study subjects will consist of parents of children 5 through 18 years old (N=2,000), children 8 through 18 years old (N=800) who are enrolled in the Florida KidCare Program (FKP) and a pediatric sample 8 through 18 years old (N=240) from three pediatric clinics. PUBLIC HEALTH RELEVANCE: IRT/CAT holds the promise of developing feasible, precise and affordable HRQOL tools for children. This K23 project will help Dr. Huang develop advanced children's HRQOL tools that can be used to measure children's health and functional status and to facilitate treatment planning and shared decision-making between parents, children and physicians